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The effect of low dose teophillyne on the improvement of copd assessment test score, interleukin-8 level and sputum neutrophil count in patients with stable COPD Yusup Subagio Sutanto; Magdalena - Sutanto; Hendra - Kurniawan
Jurnal Kedokteran Syiah Kuala Vol 19, No 3 (2019): Volume 19 Nomor 3 Desember 2019
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v19i3.17974

Background: Harmful particles from cigarette smoke induces an inflammatory immune response in the lungs, followed by the release of proinflammatory cytokines such as TNF-α and IL-8 and damages histone deacetylase 2 (HDAC2) in the cell core leading to glucocorticoid resistance in COPD. Low dose Theophylline of below 10mg/L has an anti-inflammatory effect by activating HDAC. This study aimed to analyze the effect of low dose theophylline on the clinical improvement of stable COPD patients assessed by the COPD Assessment Test (CAT) score, IL-8 level, and sputum neutrophil count.Methods: We conducted a quasi-experimental clinical study using a pre-post test in stable COPD patients visiting the Pulmonary Outpatient Clinic of DR. Moewardi hospital Surakarta, between July and September 2016. The samples were taken using a consecutive sampling technique, assigned into two groups, treatment, receiving standard therapy plus 70 mg low dose theophylline per 8 hours, and control receiving standard therapy only. CAT score, IL-8 level, and sputum neutrophil count were measured at baseline and four weeks after treatment.Results: The treatment group's CAT score decreased by 3.67±3.58 pg/ml and increased by 2.40±3.38 pg/ml in the control group (p=0.003). IL-8 level decreased by 4.31±13.06 pg/ml in the treatment group and increased by 0.88±13.89 pg/ml in the control group (p=0.116). The sputum neutrophil count decreased in both treatment and control groups by 4.00 ±40.33 pg/ml and 2. 87±39. 91 pg/ml (p=0.939).Conclusion: Statistically low dose theophylline significantly lowers the CAT score of stable COPD patients. It also decreases IL-8 level and sputum neutrophil count, although it is not significant.

FRAMEWORK KETAHANAN PUSKESMAS DALAM MENGHADAPI BENCANA Rina Suryani Oktari; Hendra Kurniawan
Jurnal Kedokteran Syiah Kuala Vol 16, No 1 (2016): Volume 16 Nomor 1 April 2016
Publisher : Universitas Syiah Kuala

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Abstrak. Mengingat pentingnya peran puskesmas dalam mengurangi jatuhnya korban jiwa pada saat terjadinya bencana, maka penting untuk mengkampanyekan konsep ketahanan puskesmas. Penulisan artikel yang didasarkan pada tinjauan literatur ini bertujuan untuk memberikan informasi latar belakang tentang kerangka umum ketahanan puskesmas dalam menghadapi bencana, mengembangkan framework serta mengidentifikasi parameter, variabel dan indikator untuk mengukur tingkat ketahanan tersebut. Framework yang berisi komponen-komponen untuk mengukur ketahanan puskesmas telah disusun, dengan mengintegrasikan langkah-langkah potensial untuk pengembangan selanjutnya menjadi sebuah instrumen evaluasi. Framework ini mengandung 5 parameter untuk mengukur tingkat ketahanan puskesmas yaitu i) kondisi fisik, ii) peran kelembagaan, iii) sumber daya manusia, iv) hubungan eksternal, dan v) keterpaparan terhadap bencana. Penelitian lebih lanjut diperlukan untuk mengembangkan dan memvalidasi instrumen yang dapat digunakan oleh puskesmas untuk melakukan kajian tingkat ketahanan. (JKS 2016; 1: 44-52)Kata kunci : Bencana, ketahanan, kesehatan, puskesmasAbstract. Given the critical role of puskesmas (community health center) to minimize the impact of a disaster, it is essential to promote puskesmas resilience concept. Through an extensive literature review, this article aims to provide background information on the general framework of puskesmas resilience in the face of disaster and identify the parameters, variables and indicators to measure the level of resilience. A conceptual framework was constructed for documentation of the measurement component of puskesmas resilience, which integrate potential measures for future development of an evaluation instrument. This framework has five parameters to measure the puskesmas resilience, namely: i) physical conditions, ii) institutional issues, iii) human resources, iv) external relationships, and v) exposure to disaster. Future research will develop and validate an instrument that will allow puskesmas to measure their level of resilience. (JKS 2016; 1: 44-52)Keywords : Disaster, resilience, health, puskesmas

Peran Faktor Lingkungan Terhadap Penyakit dan Penularan Demam Berdarah Dengue Hendra Kurniawan
Jurnal Kedokteran Syiah Kuala Vol 11, No 1 (2011): Volume 11 Nomor 1 April 2011
Publisher : Universitas Syiah Kuala

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Abstrak. Indonesia sehat tahun 2010 difokuskan pada preventif yaitu pencegahan penyakit. Demam berdarah dengue merupakan penyakit yang bisa dicegah, salah satu cara pencegahanya adalah dengan kebersihan lingkungan. Nyamuk telah tersebar luas di seluruh Indonesia, baik di rumah maupun di tempat umum. Peran faktor lingkungan terhadap penyakit terdiri dari memperhatikan Kepadatan Penduduk, mobilitas penduduk, sanitasi lingkungan, keberadaan kontainer dan kepadatan vektor. Dengan mengetahui keadaan lingkungan, maka upaya-upaya pencegahan terhadap penyakit dan penularannya dapat dilakukan dengan baik.Abstract. Policy of Healthy Indonesia in 2010 focused on the prevention of disease prevention. Dengue hemorrhagic fever is a preventable disease, one way is by pencegahanya environmental hygiene. The mosquito has spread widely throughout Indonesia, both athome and in public places. The role of environmental factors to the disease consists ofattention to Population Density, population mobility, environmental sanitation, the presence of containers and vector density. By knowing the state of the environment,then preventive measures against disease and transmission can be done well.

Kafein dalam MinumanPenambah Stamina Hendra Kurniawan
Jurnal Kedokteran Syiah Kuala Vol 9, No 1 (2009): Volume 9 Nomor 1 April 2009
Publisher : Universitas Syiah Kuala

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Abstrak. Telah dilakukan penelitian analitik dengan metode quasi eksperimental tentang pengaruh kafein dalarn minuman penambah stamina terhadap perubahan hemodinamik tubuh {tekanan darah dan nadi). Adapun Jatar belakang pcnelitian ini adalah tingginya persentase individu yang menggunakan minuman penambah energi dalam kehidupan seharl-harl.Penelitian ini dilakukan terhadap 20 orang rnahasiswa yang bersedia diberikan perlakuan, tidak memilikiriwayat penyakit sistemik (Hipertensi, Penyakit Jantung Koroner, Diabetes Mellitus ), dan tidak sedang hamil. Penelitian ini bertujuan untuk mengetahui ada tidaknya pengaruh kafein dalam minuman penambah stamina terhadap tekanan darah dan nadi.Hasil penelitian menunjukkan bahwa peningkatan tekanan darah sistolik pada 30 menit I dan UI sekitar 40 50%, sedangkan pada 30 menit ll,IV, V, dan VI cenderung stabil. Denyut nadi meningkat pada 30 menit l, II, JV, dan VI. 30 menit Ill dan IV rnenurun setelah pemberian minuman penambah stamina yang mengandung kafein sebanyak 50 mg. Berdasarkan regresi linear, didapatkan tidak terdapat hubungan antara perubahan tekanan darah dan nadi pada kelompok kontrol dan intervensi, narnun secara keseluruhan tekanan darah yang rncnlngkat belum memenuhi criteria hipertensi berdaserkan JNC 7. Perubahan denyut nadi yang terjadi juga belum memenuhi kategori takikardi maupun bradikardi. (JKS2009; 1: 9-14)Kata Kunci : Kafein, hemodinamik Abstract. The Analytic research has been done with quasi experiment method defined the influence of caffeine in energy drink and ifs hemodynamic effect(blood pressure andpulse). The background of this research Is based on increased number of people who consume energy drink recently.The student, being volunteer to be given an intervention, there's no history In systemic disease (Hypertension,Coronary Heart Disease, Diabetes Mellitus), and not in pregnancy.The goal of this research is to access whether there 're influence of caffeine in energy drink in order to blood pressure and pulse. .The result showed that in t" and 3rd 30 minutes the Systolic pressure was increased approximately 40 50%.stable in glance at 2"", 4fh (Ju,, The pulse increased in /1',2"",4"', (Jh_ 3td 51h decrease after consumed energydrink which containing 50mg of Caffeine. Based on linear regression, there 's no connection between bloodpressure and pulse changing on control and intervention group After all, the increased of blood pressure level ~didn't log on the criteria of hypertension based on JNC 7, The pulse result also didn't log on to TachycardiaorBradycardia.. (JKS 2008; 1:9-14) Keywords : Kafein, hemodinamlk

DOKTER DI LAYANAN PRIMER DENGAN PENDEKATAN KEDOKTERAN KELUARGA DALAM SISTEM PELAYANAN KESEHATAN Hendra kurniawan
Jurnal Kedokteran Syiah Kuala Vol 15, No 2 (2015): Volume 15 Nomor 2 Agustus 2015
Publisher : Universitas Syiah Kuala

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Abstrak :Tujuan pembangunan nasional adalah dengan tersedianya sistem pelayanan kesehatan yang efektif, berkualitas dan tepat sasaran. Pelayanan kesehatan yang baik dan merata hendaknya memenuhi segi ketersedian, penerimaan, keterjangkauan dan mutu yang baik. Dokter praktik umum sebagai tenaga kesehatan diupayakan untuk menjadi tulang punggung dan menangani masalah kesehatan secara paripurna pada layanan primer. Ilmu Kedokteran Keluarga dapat diterapkan dalam melakukan pelayanan. Arah kebijakan pemerintah dalam memperkuat sistem layanan primer telah tertuang dalam bentuk Undang-undang dan dibutuhkan komitmen dari semua pihak dalam pelaksanaannya.Abstract :The achievement of national development is the availability of an effective health care system, qualified and Objective of national development is the availability of an effective health care system, qualified and targeted. Good health care and equitable terms should meet the availability, acceptance, affordability and good quality. General practitioners as health workers strived to become the backbone and addressing health issues in plenary on primary care. Family Medical science can be applied in performing the service. The direction of government policy in strengthening the primary care system has been stipulated in the legislation and required commitment from all parties in the implementation. The good health care should provide the availability, acceptance, affordability and good quality. The physicians as health care workers strived to become the backbone and addressing health problem in plenary on primary care. Family medicine science could be be applied in performing the service. The direction of government policy in strengthening the primary care system has been stipulated in the legislation and required commitment from all parties in the implementation.

HUBUNGAN LAMANYA PERAWATAN PASIEN SKIZOFRENIA DENGAN STRES KELUARGA Mirza Mirza; Raihan Raihan; Hendra Kurniawan
Jurnal Kedokteran Syiah Kuala Vol 15, No 3 (2015): Volume 15 Nomor 3 Desember 2015
Publisher : Universitas Syiah Kuala

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Abstrak. Skizofrenia merupakan salah satu bentuk gangguan kejiwaan kronik. Perawatan yang lama terhadap pasien skizofrenia umumnya akan menimbulkan stres kepada keluarga terkait tingginya beban yang mereka tanggung. Penelitian ini bertujuan untuk melihat hubungan antara lamanya perawatan pasien skizofrenia dengan tingkat stres keluarga. Jenis penelitian yang digunakan adalah penelitian analitik dengan desain cross sectional survey. Pengambilan sampel dilakukan di Rumah Sakit Jiwa Aceh dengan menggunakan metode accidental sampling yang dilakukan pada 27 oktober – 27 november 2014. Jumlah responden adalah 34 orang. Seluruh responden diminta untuk mengisi kuesioner yang berisi identitas dan melakukan wawancara terpimpin dengan menggunakan kuesioner DASS yang telah dimodifikasi. Data diuji dengan uji fisher dengan signifikan α = 0,05 atau 95%. Dari 34 responden terdapat 29 responden yang tidak mengalami stres (85,3%) dan 5 responden mengalami stres ringan (14,7%). Hasil penelitian ini menunjukkan bahwa keluarga pasien skizofrenia tidak mengalami stres/normal meskipun membutuhkan waktu yang lama untuk merawat merawat pasien (p.=0,591 0,05). Kata kunci: Keluarga pasien skizofrenia, skizofrenia, lamanya perawatan, stresAbstract. Schizophrenia is a chronic (long-term) mental illness. Long duration of caring for schizophrenic patients will cause stressful event occur to their family because the increase of burden. The aim of this study was to know the association between duration of caregiving schizophrenic patients with the level of stress in their family. This study was an observational analytic study by using cross sectional survey design. Sampling was performed by accidental sampling method in Mental Health Hospital Aceh from the period October 27 till 27 November 2014. The amount of sample was 34 samples who were caregivers of schizophrenic patients. All samples were asked to fill the quesionnaire which contained identity and did interview using DASS modified questionnaire. The data was using analysis fisher’s test with a significant level α = 0,05 or 95%. Out of 34 samples obtained 29 (85,3%) of them did not stress and 5 (14,7%) respondens got mild stress. Results obtained fisher’s test with a significant level α = 0,05 or 95%. This study showed that the family of schizophrenic patients did not stress although it takes long duration of caring patients (p = 0,591 0,05). Keywords: The family of schizophrenic patients, schizophrenia, duration of caregiving, level of stress

PENTINGNYA KOMUNIKASI DALAM PELAYANAN KESEHATAN PRIMER Tita Menawati; Hendra Kurniawan
Jurnal Kedokteran Syiah Kuala Vol 15, No 2 (2015): Volume 15 Nomor 2 Agustus 2015
Publisher : Universitas Syiah Kuala

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Abstrak. Ilmu komunikasi dalam promosi kesehatan telah menjadi komponen utama. Tantangan utama dalam komunikasi kesehatan terutama dalam promosi kesehatan adalah bagaimana cara merangkul pelayanan primer dalam mensukseskan promosi kesehatan yang diberikan. Dalam profesi kedokteran komunikasi antara dokter dan pasien merupakan komponen paling penting. Permasalahan komunikasi dalam bidang kedokteran yang paling sering muncul ke permukaan disebabkan karena kurang dipahaminya komunikasi baik dokter maupun pasien.Abstract.Science communicationin health promotionhasbecome amajor component. The mainchallengein health communication, especially in the promotion ofhealthishow toembraceprimary carein the success ofhealth promotiongiven.In themedical professionof communicationbetweendoctor and patientis themostimportantcomponent. Problemsof communication inthe field of medicinemostoftencome to the surfacedue to the lackof communicationunderstoodboth doctors andpatients.

POLA PENATALAKSANAAN NYERI NEUROPATIK DI PUSAT PELAYANAN KESEHATAN PRIMER DI KOTA BANDA ACEH: THE PATTERN OF NEUROPATHIC PAIN MANAGEMENT AT PRIMARY HEALTH CARE IN BANDA ACEH Dessy Rakhmawati Emril; Alyani Akramah Basar; Desiana Desiana; Hendra Kurniawan
Jurnal Sinaps Vol. 1 No. 3 (2018): volume 1 Nomor 3, September 2018
Publisher : Neurologi Manado

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ABSTRAK Nyeri neuropatik adalah nyeri yang disebabkan karena adanya lesi atau gangguan primer pada susunan saraf. Nyeri neuropatik ditemui pada kasus-kasus seperti neuropatik DM, trigeminal neuralgia, post herpetic neuralgia, pasca stroke, pasca trauma, neuropatik HIV, radikulopati, phantom limb pain dan lain sebagainya. Golongan obat anti konvulsan dan anti depressan dapat digunakan sebagai pengobatan lini pertama dan pengobatan lini kedua diterapi dengan obat golongan anagesik opioid seperti morfin atau tramadol.Tujuan dari penelitian ini untuk mengetahui pola penatalaksanaan nyeri neuropatik yang dilakukan oleh dokter umum di pusat pelayanan kesehatan primer di Kota Banda Aceh. Penelitian ini merupakan penelitian deskriptif dengan pendekatan cross sectional survey dan telah dilakukan pada oktober – november 2014 dengan jumlah responden 72 dokter praktik umum. Hasil penelitian didapatkan seluruh dokter pernah menangani kasus nyeri neuropatik, dan 87,5% dokter pernah menangani kasus nyeri neuropatik DM, dan kasus yang paling sedikit pernah ditangani adalah neuropatik HIV. Golongan obat yang paling banyak dipilih yaitu 91,7% memilih golongan NSAID dan hanya 51,4% dokter pernah menggunakan golongan anti konvulsan sebagai terapi nyeri neuropatik. Sebanyak 40,3% dokter pernah menggunakan golongan analgesik opioid sebagai terapi nyeri dan hanya 4,2% responden yang sering menggunakannya di pusat layanan kesehatan primer di Kota Banda Aceh. Kata Kunci : Nyeri neuropatik, dokter layanan primer, terapi nyeri neuropatik ABSTRACT Neuropathic pain is pain that is caused by a lesion or a primary disorder of the nervous system. Neuropathic pain encountered in cases such as neuropathic DM, trigeminal neuralgia, post-herpetic neuralgia, post-stroke, post-traumatic, neuropathic HIV, radiculopathy, phantom limb pain, and so forth. Drug classes anticonvulsants and anti-depressants can be used as first-line treatment and second-line treatment were treated with drugs known as opioids such as morphine anagesik or tramadol. The purpose of this study was to determine the pattern of neuropathic pain management performed by general practitioners in primary health care centers in Banda Aceh. This research is a descriptive cross sectional survey has been done in October - November 2014, with the number of respondents 72 general practitioners. The results showed all doctors had handled the case of neuropathic pain, and 87.5% of physicians had one case of DM neuropathic pain, and the fewest cases ever handled was neuropathic HIV. Classes of drugs most widely chosen that 91.7% chose NSAID group and only 51.4% of physicians have used class of anticonvulsants in the treatment of neuropathic pain. As pain therapy obtained 40.3% of physicians have used class of opioid analgesics and only 4.2% of respondents who are often use in primary health care centers in Banda Aceh. Keywords : Neurpathic pain, primary care physician, treatment of neuropathic pain

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